Introduction

There are an estimated 600,000 to 800,000 needlesticks and other skin punctures or cuts among health care workers each year. About half of these incidents are not reported to employers. A needlestick or other exposure from a used needle or other sharp device carries the risk of infection with serious and even deadly diseases such as HIV/AIDS and hepatitis.

Needlesticks should NOT be considered "accidents" that are just part of the job, or the result of careless workers. Health care workers get stuck because they are provided with unsafe needles and other devices. The risk of needlesticks increases under stressful conditions to meet the needs of patients in facilities that often do not have enough staff.

In 1986, AFSCME was the first organization to demand a law to protect health care and other workers from HIV/AIDS, hepatitis and other bloodborne diseases. Six years later, the Occupational Safety and Health Administration (OSHA) issued the Bloodborne Pathogens Standard (BBP), a major victory for workers’ safety. Implementation of the protections contained in this standard has saved thousands of lives since it became law in 1991.

OSHA’s standard, however, did not go far enough to protect against needlesticks and other sharps injuries. Safer needles and other medical devices proven to reduce the risk of injuries have been available for years, but far too many health care employers have failed to voluntarily switch to safer devices. Therefore, AFSCME played a leading role in the passage of the Needlestick Safety and Prevention Act of 2000. This law directed OSHA to revise the Bloodborne Pathogens Standard to require the use of safer devices. It further amended the standard to require that non-managerial frontline health care workers have input into the selection of needles and other devices. Employers must now record needlesticks on a sharps injury log.

Unfortunately, the Bloodborne Pathogens Standard does not apply to all workers at risk for needlesticks. Public employees are only covered in states that have OSHA or specific needlestick laws that protect state and local government workers. Workers not covered by federal or state OSHA laws can secure similar protections through collective bargaining.

This publication describes why needlesticks and other sharps injuries occur and how safety equipment and other measures can prevent these incidents. It will help workers and union representatives to understand and to exercise their rights to prevent needlesticks. This booklet includes recommendations for committees, contract language and other strategies to ensure that all necessary measures are taken to prevent needlesticks and other sharps injuries.